Intervening with persons experiencing mental illness and substance use: Patient perceptions of helpful care during psychiatric hospitalization

Background30 - 50% of people with mental illness also experience a substance use problem or concurrent disorder (CD). This dual diagnosis is associated with complex health and social problems, high suicide risk and poor longterm outcomes. Persons with CD have unique needs which present significant challenges for health providers during psychiatric hospitalization. While hospital personnel play a significant role in promoting health and well-being, what “helpful care” means to persons with CD during psychiatric hospitalization remains unexplored, and the health benefits unknown. Research QuestionWhat actual and/or potential interventions, attitudes, actions, and behaviours are perceived as “helpful” by persons with CD during psychiatric hospitalization?MethodsQualitative-descriptive design; individual, semi-structured audio-recorded interviews with 12 inpatient adults diagnosed with CD.ResultsParticipants reported both beneficial and harmful practices.Examples of helpful interventions occurred within 3 distinct areas: 1) building a therapeutic relationship; 2) engaging in health-promoting activities within a healing environment; 3) managing substance use in tandem with mental illness. ImplicationsFindings highlight the importance of relational interventions for persons with CD. This includes actions aimed at tailoring care to fit each individual while offering interpersonal approaches, attitudes and behaviours that are collaborative, caring and respectful. Helpful activities include assisting with daily care, advocating for time outside, offering teaching and learning sessions and facilitating discharge. There is an urgent call to prevent harmful practices and to understand and promote interventions consistent with whole person care for hospitalized clients with CD

Unexpected Rift Valley Fever Outbreak, Northern Mauritania

During September–October 2010, an unprecedented outbreak of Rift Valley fever was reported in the northern Sahelian region of Mauritania after exceptionally heavy rainfall. Camels probably played a central role in the local amplification of the virus. We describe the main clinical signs (hemorrhagic fever, icterus, and nervous symptoms) observed during the outbreak

Bioeconomic analysis of the Mauritanian cephalopods fishery*

Abstract Cephalopods represent a very significant fishing resource in Mauritania. In particular, Octopus vulgaris (Cuvier 1797) whose value increases according to weight is the most valuable species. The resource shows significant inter annual variations in abundance related to the varying environmental conditions off Mauritania and the previously conducted species stock assessments indicate a state of overexploitation and growth over fishing. A bioeconomic single species population dynamics model is developed to estimate the combined impact of fishing closure duration and timing and minimum size at capture in various hypothetical exploitation scenarios to the yearly yield, value of yield and spawning stock biomass. Applying monthly cohort analysis in a Bayesian framework using MCMC sampling enabled us to implement the model with the variability observed in seasonal and inter annual environmental conditions and the uncertainty related to different aspects of the species biology. The currently applied management measure, a two-month closing season in September-October with a minimum size at capture of 500 g, is used as the reference point. The results indicate that the current timing of the closed season is optimal and no considerable gains in value of yield are obtained using other timings. However, increasing the minimum size at capture seems to be profitable. For example, minimum size of 1000 g with a two-month closing season in September-October yields a mean relative gain of 16 % in yearly value of yield. The findings of this study will contribute to the sustainable use of cephalopod fishery resources in Mauritania by providing indicators for the economically optimal harvest of the species. The methodology applied in this study aims to be applicable also to other cephalopods fisheries. This paper was prepared as part of E U 6 th framework programme project "Probabilistic assessment, management and advice model for fishery management in the case of poor data availability" (POORFISH), contract no. 22745

Probabilistic assessment, management and advice model for fishery management in the case of poor data availability: the EU POORFISH project

The objective of the European POORFISH project (2005-2008) is to create an advisory system (assessment, advice, and/or management) approach based on methods able to deal with data poor systems (utilizing both expert knowledge and published information in addition to existing data sets). There are basically at least three types of data poor situations: § Small scale fisheries with usually several target species of otherwise mixed fisheries (many coastal fisheries in Mediterranean and northern Baltic areas) § Large scale, but recently developed fisheries (many deep sea fisheries belong to this group) § Large scale fisheries, where the quality of data is getting worse (poor data due to e.g. misreporting and discarding) The paper will present the methodology developed in the project and it first application of to selected fisheries in the Baltic Sea, North Sea, Mediterranean Sea and along West African coasts

Stratégie de prévention des complications peptiques du RGO

Le reflux gastro-œsophagien pathologique est une affection très fréquente en milieu pédiatrique, et sa gravité réside dans le risque des complications peptiques qui peuvent être lourdes de conséquences. L’œsophagite peptique qui est définie comme l’ensemble des lésions inflammatoires des tuniques œsophagiennes, constitue la complication la plus fréquente et la plus redoutable, du fait de son risque d’évolution vers la sténose peptique. Cette étude est une étude rétrospective 102 cas de patients atteints de RGO suspect d’être compliqué d’une œsophagite et/ou d’une sténose peptique, colligés à l’unité de gastro-entérologie et de nutrition a l’HER entre mars 2009 et juillet 2012. L’objectif est d’évaluer la gravité et la prévalence des complications peptiques du RGO et d’élaborer une stratégie de prévention de ces complications. Parmi les 102 cas de RGO étudiés, les complications peptiques ont été retrouvées chez 84malades, soit une prévalence de 82.4%, dont 22,4% grade 3 et 14,4% grade 4. Les formes compliquées d’œsophagites peptiques sont surtout retrouvées dans la tranche d’âge 24 mois 6 ans dans 35,2% des cas, avec une prédominance masculine (sexe ratio de1.2) Le tableau clinique a comporté essentiellement les vomissements ou les régurgitations dans31.4% des cas, les hémorragies digestives dans22.5%. En conclusion, il faut noter que la fréquence des complications peptiques du RGO, dans notre étude reste très élevée ce qui nécessite une stratégie de prise en charge plus agressive basée sur l’élargissement de l’indication de l’endoscopie, la facilité des prescriptions médicamenteuses (IPP,anti H2) en cas de complication, et un meilleur dépistage et suivi du RGO avant le stade de complications, en plus du traitement hygiéno-diététique et des efforts de sensibilisation à la fois auprès du public, des médecins généralistes et des pédiatres

The union for the Mediterranean : a political project difficult to implement : a few major obstacles

Résumé confidentielConfidential abstrac

L'accès au système de santé en Mauritanie : Problèmes de capabilities et défis institutionnels

Mauritania has developed specific health policies for a long time. The country remains, however, highly affected by strong inequalities and difficulties concerning healthcare accessibility. In a first section, we propose an analytical framework following the capability approach and A. Sen ¿s works. We focus on different forms of accessibility in the case of healthcare. In a second section, we illustrate this framework using mauritanian data. Finally, we conclude on the idea of health threshold as reference mark for local population accessibility to health.accessibility, capability, health threshold

AN INDEXING APPROACH FOR THE ASSESSMENT OF HEAVY METALS IN DRINKING WATER PRODUCED BY MAURITANIAN WATER TREATMENT PLANT

In the present work, the assessment of drinking water quality was carried out through a monitoring of heavy metals in the treated and consumed waters in the city of Nouakchott (Mauritania). Monthly sampling was conducted for a period of 24 months between January 2012 and December 2013. Nine parameters were evaluated: pH, T (°C), Turbidity (NTU), Al, Fe, Cu, Mn, Al2(SO4)3 and CaO. Indexing approaches have been applied by calculating the Heavy Metal Pollution Index (HPI) and Metal Index (MI) for the assessment of influence of heavy metals on the overall quality of water. The obtained results for heavy metals are in good agreement with World Health Organization (WHO) standards. Though the aluminum concentration remains in the limits set by WHO, yet it shows a major contribution in the indices. This has been verified by the statistical analysis which demonstrates fair correlations between aluminum, HPI (r = 0.9) and MI (r = 0.77). Aluminum showed the important influence of seasonal change in the year as well as the doses of reagents injected during the treatment process on the concentration of aluminum is detailed